Federal Employee Health Benefits (FEHB) Program

Federal Employee Health Benefits (FEHB) Program

Triple-S Salud has proudly worked for nearly 60 years, offering great service to federal employees, retirees, and their families. This Health Plan is offered and managed by Triple-S Salud. It offers local coverage to people residing in Puerto Rico (PR) and the US Virgin Islands (USVI). To learn more, please contact our Customer Service Call Center at 787-774-6081 or 1-800-716-6081, (toll free). TTY/TDD users should call 787-792-1370 or 1-866-215-1999. Our call center is available Monday thru Friday from 7:30 AM to 8:00 PM, Saturdays from 9:00 AM to 6:00 PM and Sundays from 11:00 AM to 5:00 PM – AST (Atlantic Standard Time).

Types of Enrollment

Self plus One – federal employee or retiree and one (1) eligible dependent

Self and family – federal employee or retiree and two (2) or more eligible dependents

Eligible Dependents

Legally married spouse.

Natural children, adopted and stepchildren are covered until their 26th birthday. It does not matter if they are married, studying, or working.

Children that cannot support themselves because of a mental or physical handicap that began before the age of 26. It must be approved by the agency or OPM as it may apply.

Foster children are considered for coverage only if the employee or retiree shows documents as proof of the regular and main support of the child. It must be approved by the agency or OPM as it may apply.

Programs and Benefits

Salus is a network of multidisciplinary clinics designed to facilitate health care. The clinics offer primary physician services, over 40 specialists, dentists, access to diagnostic tests and integrated programs where you can receive several services on the same day. Click here for more information.

This tool allows you to talk to a doctor through your mobile device or computer. Avoid long waits in an emergency room and have a virtual visit with a doctor. You have up to four consults per member with a $10 copay within our service area. Click here for more information.

Because saving is healthy, Triple-S Salud provides you a world of offers with Blue365.

When you register you’ll enjoy discounts on many products and services to improve or maintain your health and wellness:

Financial Health

Nutrition and Diet

Personal Care

Fitness

Lifestyle

Wellness

This program focuses on giving Federal employees or retirees the opportunity to receive health @ work resulting in a creative, convenient and effective way to practice awareness and prevention. Ask your agency for the next activities.

You pay $7.50 per office visit to a psychiatrist, psychologist, and social workers

Mental Health, Total Health
The mental health program for Federal Employees aims to provide adequate care for mental health conditions and substance use, to help improve the overall health of the insured.

The program is available 24 hours a day and includes visits to a psychiatrist, social workers and psychologists, partial and regular hospitalization.

Except for Antihypertensives (medications known as ACE Inhibitors, ARBs and Direct Renin Inhibitors), Antidiabetics (excludes insulins), Ahtihyperlipidemics (includes only statins) which will have $0 copay.

Preferred Brand Drugs: You pay $20 per unit or refill (30 days)

Non-Preferred Brand Name Drugs: You pay 20% or $20, whichever is higher, up to $125 per unit or refill (30 days)

Preferred Specialty Drugs: You pay 25% or $200, whichever is the lowest, per unit or refill. Only through certain specialty drug stores.

Non Preferred Specialty Drugs: You pay 30% or $300, whichever is the lowest, per unit or refill. Only through certain specialty drug stores.

Drug Cost Calculator

By using the Drug Cost Calculator you can see an estimate of how much you will pay for your covered medicine, and learn about the different treatments for you under your plan.

*Disclaimer
These prices show the most current cost information, but sometimes it will not necessarily be the same as the real cost. These estimated drug prices could change. There is an amount that the member must pay to get the medicine, and it depends on the pharmacy coverage.

This may mean a fixed amount or percentage of the price. It will be based on the rate of the plan for each prescription. To get the amount, the maximum number of day supply and what is normally dispensed is used. This is why it may not show the prescribed dose.

Flex 90 Program

You can get a 90-day supply for certain maintenance drugs in our Program pharmacies. All you need is to ask your doctor for a prescription 90 days plus one (1) refill of your maintenance drugs.

We cover medical emergencies and pre-authorized services only. When you get covered services outside the area that are neither emergency nor pre-authorized, we will pay back 90% of Triple-S Salud’s established fees, after any copay or coinsurance that applies. You are responsible up to the billed charges for these services.

Federal Policy (FEHB) 2019

SBC FEHB 2019

The Summary of Benefits and Coverage (SBC) is a document created by the National Association of Insurance Commissioners (NAIC) that will help consumers understand, compare and make better decisions about their health coverage.

Federal Policy (FEHB) 2018

SBC FEHB 2018

The Summary of Benefits and Coverage (SBC) is a document created by the National Association of Insurance Commissioners (NAIC) that will help consumers understand, compare and make better decisions about their health coverage.

Triple-S Salud is an independent licensee of BlueCross BlueShield Association whose service area is Puerto Rico. Triple-S Salud is a subsidiary of Triple-S Management Corporation. Triple-S Salud, Inc. is an insurer, duly authorized by the Office of the Commissioner of Insurance of Puerto Rico, license number 3117057/NAIC #55816. Our employees tasked with offering, soliciting, and selling health insurance are representatives authorized by the Office of the Commissioner of Insurance of Puerto Rico to broker this type of health insurance in Puerto Rico. Insurance products are not deposits, are not insured by the FDIC or other federal agencies, and are not guaranteed by the Bank. Triple-S Salud, Inc. will not use any personal information you provide for purposes other than the sale of an insurance policy.

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